Provider Demographics
NPI:1538816863
Name:MARY K DOHERTY LICSW& MAURA PILOTTE LICSW COUNSELING LLC
Entity type:Organization
Organization Name:MARY K DOHERTY LICSW& MAURA PILOTTE LICSW COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR/CO- OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:K
Authorized Official - Last Name:DOHERTY
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:781-710-3420
Mailing Address - Street 1:8 FRONT ST STE 215
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-3745
Mailing Address - Country:US
Mailing Address - Phone:781-710-3420
Mailing Address - Fax:
Practice Address - Street 1:8 FRONT ST STE 215
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-3745
Practice Address - Country:US
Practice Address - Phone:781-710-3420
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-07
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health